Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

Authors: Izzuddin M. Aris, et al

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Previous studies have linked food insecurity with obesity in adults, but evidence around the impact in children isn’t as clear. Many of these studies have looked at food insecurity and obesity at a single point in time rather than following the children over time. Because of this, it’s difficult to understand whether childhood obesity is directly influenced by food insecurity. Additionally, the few long-term studies that have addressed food insecurity and childhood obesity have primarily focused on late childhood or adolescence. ECHO Cohort researchers aimed to explore how food insecurity during pregnancy and early life—stages that may be particularly important to influencing long-term health outcomes—could be related to obesity in childhood and adolescence.

 

What were the study results?

Children who lived in low-income, low-food-access (LILA) neighborhoods during early childhood or whose mothers lived there during pregnancy were found to have higher body mass index (BMI) at ages 5 and 15. Living in those conditions was also associated with a 50% greater chance of developing obesity or severe obesity at ages 5, 10, and 15 years—regardless of individual sociodemographic factors. The association was strongest for those living in LILA neighborhoods during early childhood and their mother’s pregnancy. A LILA neighborhood is defined as a low-income neighborhood where a third or more residents live more than one half mile from a grocery store in urban areas or more than 10 miles in rural areas.

 

What was this study's impact?

These findings suggest that pregnancy and early childhood may be life stages when neighborhood food access can play the biggest role in long-term health outcomes. Living in neighborhoods with access to healthy foods during these stages may be important in preventing the development of obesity later in childhood and adolescence.

 

Who was involved?

The study included 28,359 participants from 55 ECHO Cohort Study Sites, including racially, ethnically, and geographically diverse mother-child pairs. Approximately 23% of the participants lived in a LILA neighborhood during pregnancy, and around 24% lived in these areas during early childhood.

 

What happened during the study?

Researchers mapped out where participants lived during pregnancy (from 1994 to 2023) or early childhood (from 1999 to 2023), matching each address to a specific neighborhood based on census data. They then linked these neighborhoods to food access data from the USDA Food Access Research Atlas for the years closest to when the participants lived there. The database offers information on household income, vehicle availability, and food access in neighborhoods.

Child weight and height data were collected from birth to adolescence through in-person research visits, medical records, and parent or caregiver reports. Researchers compared this data with information on where the children lived to determine if there was a link between neighborhood food access and child BMI or obesity.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Future studies are needed to learn whether improving access to healthy food early in life helps prevent childhood obesity. Improvements could include encouraging new supermarkets in existing food deserts, offering healthy food options at food pantries, or making healthier choices available in small retail and convenience stores.

 

Where can I learn more?

Access the full journal article, titled “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity,” in JAMA Pediatrics.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published September 16, 2024

 

Read the associated article.

Food Insecurity in Early Life, Pregnancy May Be Linked to Higher Chance of Obesity in Children, NIH-Funded Study Finds

FOR IMMEDIATE RELEASE

 

Family in grocery store

The study explores the effects of low-income, low-food-access neighborhoods on children’s obesity over time.

Children who faced food insecurity during early childhood—or whose mothers experienced it during pregnancy—had a higher body mass index (BMI) and more than 50% increased chance of developing obesity or severe obesity in childhood and adolescence, according to a new study funded by the NIH Environmental influences on Child Health Outcomes (ECHO) Program.

While previous research has linked food insecurity to obesity in adults, its impact on children is less clear. ECHO Cohort researchers explored how food insecurity during early life and pregnancy may affect the incidence of obesity in childhood and adolescence.

“Living in neighborhoods with access to healthy foods during these stages may be an important factor in preventing the development of obesity later in childhood and adolescence,” said Izzuddin M. Aris, PhD of the Harvard Pilgrim Health Care Institute. “Our findings support the need for further research on strategies to improve access to healthy food in early life.”

The study looked at data from nearly 30,000 mother-child pairs from 55 ECHO Cohort research sites nationwide. About 23% had mothers who lived in an area with limited access to grocery stores during pregnancy, and around 24% of the children lived in these areas during early childhood. Low-income-low-food-access (LILA) refers to a neighborhood with a third or more residents living more than one-half mile from a grocery store in urban areas or more than 10 miles in rural areas.

Key findings include:

  • Living in LILA neighborhoods during pregnancy or early childhood was associated with a higher BMI in the child at ages 5 and 15 and a more than 50% higher chance of developing obesity or severe obesity at ages 5, 10, and 15.
  • The associations became stronger as the children aged and were strongest among those who lived in LILA neighborhoods during early childhood and their mother’s pregnancy.

Researchers used participants' residential addresses from either pregnancy (1994 to 2023) or early childhood (1999 to 2023). They then matched these addresses with food access data from the USDA Food Access Research Atlas, which provides information on household income, vehicle availability, and neighborhood food access.

Data on children's weight and height were collected from birth through adolescence through in-person visits, medical records, and parent or caregiver reports. Researchers analyzed this data alongside the neighborhood information to investigate the relationship between food access and child BMI or obesity.

This collaborative research is published in JAMA Pediatrics.

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Aris, I.M., “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity in ECHO.” JAMA Pediatrics. DOI: 10.1001/jamapediatrics.2024.3459.

About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

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